| NPI | 1235149733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: FL PO4218) |
| Additional Taxonomies | 213ES0131X (Licence: PA SC004702L) |
| 213ES0131X (Licence: NJ 25MD00273D) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2025-04-23 |